Diabetes Discovery – Via The Eyes
Did you know that an eye exam can be the first clue to detecting diabetes and other hidden health concerns? Finding health issues early can give patients a better chance at preventing damage through early treatment and management. A routine eye exam can show so many things. Some can be downright life changing – and life-saving – for that matter. One doctor found out first-hand when she did the same thing she does every day – she looked into a patient's eyes. But this was no ordinary exam. When Kathleen Clary, OD, peered into her 48-year-old patient’s eyes, she saw blood and other fluids seeping out of fragile and miniscule vessels in her retinas. The retina is the light and sight-sensing back part of the eye – and without it, you don't see. “As soon as I noticed the leaking fluids and the hemorrhaging, I suspected that they might be symptoms of diabetes,” recalls Dr. Clary, who practices in the Washington, D.C., suburb of Ashburn, Virginia. “In my 12 years of experience as an eye doctor, that kind of bleeding usually signals that a buildup of sugar in the patient’s bloodstream has begun to break down the capillaries that feed the retina. The result is often what we call diabetic retinopathy – a condition in which continuing damage to retinal tissue from diabetes can lead to impaired vision or even blindness, if left untreated.” The eye exam was the very first clue the patient had that she might have diabetes. Dr. Clary talked with her patient about what she saw and explained what it could mean. “I want you to have your blood sugar level checked right away by your family doctor,” she told her patient. “Tell the doctor you need to be evaluated for diabetes with a fasting blood sugar test, because your optometrist noticed some retinal bleeding. Continue reading >>
Diabetic Retinopathy Screening And Tests
Tweet A once yearly retinal screening appointment (eye check) is carried out to identify early signs of diabetic retinopathy. If allowed to develop, diabetic retinopathy can lead to blindness. For this reason it is important to attend your retinal screening once a year. Do I qualify for diabetic retinopathy screening? Everyone with diabetes who is 12 years of age or over should receive a retinal examination once a year as part of the NHS’s retinal screening programme. If you are concerned that you may be developing retinopathy, check for retinopathy symptoms and see your GP. Ask your GP or healthy centre if you have not received an invitation to have a retinopathy screening appointment. Who carries out the retinal screening? You may have the screening either at a hospital or you may be invited to book your appointment with an optician in your area. The screening is free regardless of where it takes place. What happens at the retinopathy screening? The optician will take a photo of your retina. To do this they will need to clearly see into as much of the back of your eye as possible. To enable them, to do this they will give you eye drops which will expand your pupils. It may take up to 20 minutes for the pupils to get large enough. The eye drops can sting a bit so just be ready. Try to keep your eyes open as best you can to avoid having to having to have additional attempts. The fluid needs to cover the centre of your eye to make your pupils larger. When your pupils are sufficiently expanded the optician will sit you down in front of a machine which will take the photograph of the retina in each of your eyes. Your eyes must be fully open for a good photograph to be achieved. Be aware that it may take a few attempts to get the photograph just right. As well as taking a Continue reading >>
Early Diagnosis Of Diabetic Retinopathy In Primary Care
Early diagnosis of diabetic retinopathy in primary care Diagnstico temprano de retinopata diabtica en el primer nivel de atencin 1 Coordinacin Auxiliar de Investigacin en Salud, IMSS Quintana Roo, Cancn, Mexico 6 Clinical and epidemiological research group of Instituto Mexicano del Seguro Social in Quintana Roo. Cancn, Mexico Find articles by Maria Valeria Jimenez-Baez 2 Servicio de Cardiopatas Congnitas, Hospital de Cardiologa, Centro Mdico Nacional Siglo XXI, IMSS, Mxico, Distrito Federal. 6 Clinical and epidemiological research group of Instituto Mexicano del Seguro Social in Quintana Roo. Cancn, Mexico Find articles by Horacio Marquez-Gonzalez 3 Instituto Mexicano del Seguro Social, Hospital Gineco Pediatra No. 07. Cancn Quintana Roo, Mexico 6 Clinical and epidemiological research group of Instituto Mexicano del Seguro Social in Quintana Roo. Cancn, Mexico Find articles by Rodolfo Barcenas-Contreras 4 Servicio de Oftalmologa, Hospital Regional No 17, Instituto Mexicano del Seguro Social Quintana Roo. Cancn, Mexico 6 Clinical and epidemiological research group of Instituto Mexicano del Seguro Social in Quintana Roo. Cancn, Mexico 5 Hospital General de Zona No. 3. Instituto Mexicano del Seguro Social Quintana Roo. Cancn, Mexico 6 Clinical and epidemiological research group of Instituto Mexicano del Seguro Social in Quintana Roo. Cancn, Mexico Find articles by Laura Fatima Espinosa-Garcia 1 Coordinacin Auxiliar de Investigacin en Salud, IMSS Quintana Roo, Cancn, Mexico 2 Servicio de Cardiopatas Congnitas, Hospital de Cardiologa, Centro Mdico Nacional Siglo XXI, IMSS, Mxico, Distrito Federal. 3 Instituto Mexicano del Seguro Social, Hospital Gineco Pediatra No. 07. Cancn Quintana Roo, Mexico 4 Servicio de Oftalmologa, Hospital Regional No 17, Instituto Mexicano del Segu Continue reading >>
Diabetic Retinopathy - Exams And Tests
Diabetic retinopathy can be detected during a dilated eye exam by an ophthalmologist or optometrist. An exam by your primary doctor, during which your eyes are not dilated, is not an adequate substitute for a full exam done by an ophthalmologist. Eye exams for people with diabetes can include: Visual acuity testing. Visual acuity testing measures the eye's ability to focus and to see details at near and far distances. It can help detect vision loss and other problems. Ophthalmoscopy and slit lamp exam. These tests allow your doctor to see the back of the eye and other structures within the eye. They may be used to detect clouding of the lens (cataract), changes in the retina, and other problems. Gonioscopy. Gonioscopy is used to find out whether the area where fluid drains out of your eye (called the drainage angle) is open or closed. This test is done if your doctor thinks you may have glaucoma, a group of eye diseases that can cause blindness by damaging the optic nerve. Tonometry. This test measures the pressure inside the eye, which is called intraocular pressure (IOP). It is used to help detect glaucoma. Diabetes can increase your risk of glaucoma. Your doctor may also do a test called an optical coherence tomography (OCT) to check for fluid in your retina. Sometimes a fluorescein angiogram is done to check for and locate leaking blood vessels in the retina, especially if you have symptoms, such as blurred or distorted vision, that suggest damage to or swelling of the retina. Fundus photography can track changes in the eye over time in people who have diabetic retinopathy and especially in those who have been treated for it. Fundus photography produces accurate pictures of the back of the eye (the fundus). An eye doctor can compare photographs taken at different ti Continue reading >>
Diagnosis Of Diabetic Retinopathy
Type 1 diabetes was previously called insulin-dependent diabetes or juvenile-onset. This form usually affects children and young adults and accounts for 5 to 10 percent of all cases of diabetes. Type 2 diabetes was previously called non-insulin-dependent or adult-onset diabetes and it accounts for about 90 to 95 percent of all case of diabetes. Type 2 is associated with older age, obesity, family history of diabetes, physical inactivity, prior history of gestational diabetes and race. African Americans, Native Americans and Latino Americans are at particularly high risk for type 2 diabetes. Type 2 diabetes is increasingly being diagnosed in children and adolescents along with increased obesity in the U.S. Non-proliferative diabetic retinopathy, which involves swelling within the eye, but no abnormal formation of blood vessels Proliferative diabetic retinopathy, in which abnormal new blood vessel form in the retina and vitreous gel of the eye Unfortunately, diabetic retinopathy gives no warning symptoms. By the time a patient notices floaters or visual loss, there is already a significant amount of diabetic retinopathy. With proper education and attention, diabetic patients should seek regular eye examinations for better preventive care. With proper treatment, loss of vision can be prevented. Fluorescein angiography is frequently used in the management of diabetic retinopathy. Fluorescein dye is injected into an arm vein, and as it courses through the retina, special pictures are taken of the interior of the eye by a professional photographer. It is a very informative tool used to evaluate retinal circulation, presence of macular leakage and retinal new blood vessels. Based on this information, the ophthalmologist will then determine whether treatment is necessary. Most Continue reading >>
Diabetic Retinopathy
Diabetic retinopathy is caused by changes in the blood vessels of the retina. When these blood vessels are damaged, they may leak blood and grow fragile new vessels. When the nerve cells are damaged, vision is impaired. These changes can result in blurring of your vision, hemorrhage into your eye, or, if untreated, retinal detachment. Diabetic retinopathy is the most common diabetic eye disease and a leading cause of blindness in the United States. What Is Diabetic Retinopathy, Testing, and Treatments Watch these video animations to learn more about diabeticretinopathy, the affect that the diabetic retinopathy has on the eyes,and tests and treatments options for the condition. The symptoms described above may not necessarily mean that you have diabetic retinopathy. However, if you experience one or more of these symptoms, contact your ophthalmologist for a complete exam. It is also important to note that pregnancy and high blood pressure may aggravate diabetic retinopathy. People with untreated diabetes are 25 times more at risk for blindness than the general population. The longer a person has had diabetes, the higher the risk of developing diabetic retinopathy. Fortunately, with regular, proper eye care and treatment when necessary, the incidence of severe vision loss has been greatly reduced. If you have diabetes, your ophthalmologist can help to prevent serious vision problems. Diabetic retinopathy can cause vision loss in two ways: Macular Edema Macular edema is a condition where your retinal blood vessels develop tiny leaks. When this occurs, blood and fluid leak from the retinal blood vessels and fatty material (called exudate) is deposited in the retina. This causes swelling of the retina and is called diabetic macular edema. When this swelling occurs in the ce Continue reading >>
Lighthouse International - Diabetic Retinopathy Diagnosis
You've come a long way, baby. Thirty years ago, your chances of going blind within five years of being diagnosed with severe diabetic retinopathy were no better than 50/50. Today, the same diagnosis gives you a 90% chance of saving your sight. There's just one little catch: If you have type 1 or type 2 diabetes (visit What is Diabetic Retinopathy to learn about the differences) you must have a comprehensive dilated eye examination every year even if you have no symptoms. Preserving your sight is a gamble that depends more on strategy than on luckbut it's a game you simply must not walk away from. Remember, adults and children age 10 and older who have diabetes should have a comprehensive dilated eye examination every year even if they have no symptoms. An immediate eye exam is in order if you recognize yourself below: You've had Type 1 diabetes for a year or more and have not had an exam in over a year You have Type 2 diabetes and have not had an exam in a year or longer You have a child with diabetes who has reached puberty You're pregnant or are planning to become pregnant and have diabetes The Retasure retinal imaging device is a new tool that allows you to be screened for diabetic retinopathy at a primary care physician's office. The device takes a quick, painless digital photo of the macula and optic nerve. This photo is transmitted via a secure network to an ophthalmologist at an accredited reading center. Results are available within a few days, and you'll be referred to an ophthalmologist for a complete examination and possible treatment if signs of retinopathy are discovered. However, the Retasure network is limited to several hundred primary care offices that subscribe to the service and have the necessary camera and hardware on the premises; unless you live Continue reading >>
How To Diagnose Diabetic Retinopathy - Retina Specialist | Fairfax, Virginia | Retinal Diseases
The retina is the only part of the eye affected by diabetes. The only way to diagnose diabetic retinopathy is by direct visualization of the retina. Your eye doctor should be able to dilate your eyes and, by simply looking at your retina, diagnose the disease. Thats all. Symptoms are the effects of a disease. These are what a patient feels, not what a doctor sees. Complaints of blurry vision, pain, shortness of breath, nervousnessall are types of symptoms. The disease, diabetic retinopathy, can cause mild blurriness to complete blindness, or nothing at all. Many patients see perfectly, yet have the disease. They just dont know it. This is the danger of diabetic retinopathy. Just like high blood pressure, it may cause absolutely no symptoms. A normal eye exam does not always include dilation of the pupils. Every diabetic patient must have the pupils dilated at least annually. These are the recommendations of the American Academy of Ophthalmology and the American Optometric Association. Why? A dilated exam is the only way to examine the retina. A dilated exam is the only way your doctor can see the characteristic changes of diabetic retinopathy. There are no diagnostic tests for diabetic retinopathy. In the absence of symptoms, the diabetic retinopathy can still be diagnosed. Early detection means preventing loss of vision. Fluorescein angiography and OCT ( optical coherence tomography ) are used commonly to study some of the aspects of your retina (i.e. is there retinal swelling?), but neither are necessary for the diagnosis. The only way to diagnose diabetic retinopathy is for somone to see it. What Does This Mean? Diabetic eye disease can be silent. Many people believe that the absence of symptoms means the absence of disease. Obviously not true. The patients with who Continue reading >>
Diabetic Retinopathy Diagnosis
Diabetic retinopathy may present with little or no symptoms in the early stages of disease. Diabetics with more long-term disease may develop symptoms and, eventually, irreversible damage to the retina may occur. Diabetic retinopathy therefore needs to be diagnosed early on in diabetic patients and routine screening and monitoring is of vital importance in order to preserve vision among these individuals. New retinal imaging scanner may one day revolutionize eye care The blindness that can eventually be caused by diabetic retinopathy cannot be reversed. Diabetics who are aged 12 years or over need to attend annual checks for the condition. If diabetic retinopathy is detected in the early stages, it can be treated using laser treatment. For screening, the pupils of the eyes are dilated using certain medicated eye drops and photographs of the retina are then taken. The eye drops may cause blurring of vision for around 5 to 6 hours depending on the type of drops used. For diagnosis of diabetic retinopathy to be confirmed, several tests are employed: Visual acuity is tested by assessing a person's ability to read a chart displaying random letters and numbers at various distances. Ophthalmoscopy or fundoscopy is performed to look inside the fundus of the eye and determine retinal health. A device called an ophthalmoscope contains a light and a special magnifying glass for examining the fundus. Optical coherence tomography is a type of visualization technique that provides high resolution images of retinal structures. The layers of the retina can be differentiated and retinal thickness can be determined. Slit lamp biomicroscopy is an important diagnostic technique for examining anterior eye structures and the retina at variable magnifications. Fluorescein angiography is perf Continue reading >>
Diabetic Retinopathy
On this page: Diabetes and diabetic retinopathy • DR symptoms • Types of diabetic eye disease • Who gets diabetic retinopathy? • Minorities and diabetic eye disease • When is DR a disability? • Eye exam assistance program • Prevention • Diabetic retinopathy videos Diabetic retinopathy — vision-threatening damage to the retina of the eye caused by diabetes — is the leading cause of blindness among working-age Americans. The good news: Diabetic retinopathy often can be prevented with early detection, proper management of your diabetes and routine eye exams performed by your optometrist or ophthalmologist. According to the International Diabetes Federation (IDF), the United States has the highest rate of diabetes among 38 developed nations, with approximately 30 million Americans — roughly 11 percent of the U.S. population between the ages of 20 and 79 — having the disease. About 90 percent of Americans with diabetes have type 2 diabetes, which develops when the the body fails to produce enough insulin — a hormone secreted by the pancreas that enables dietary sugar to enter the cells of the body — or the body becomes resistant to insulin. This causes glucose (sugar) levels in the bloodstream to rise and can eventually damage the eyes, kidneys, nerves or heart, according to the American Diabetes Association (ADA). Risk factors for type 2 diabetes include obesity, an unhealthful diet and physical inactivity. Unfortunately, the prevalence of obesity and type 2 diabetes has increased significantly in the United States over the past 30 years. According to data released by the U.S. Centers for Disease Control and Prevention (CDC) in December 2015, there were 1.4 million new cases of diabetes reported in the U.S. in 2014. Though this annual number is d Continue reading >>
Diabetic Retinopathy
Retinal consequence of chronic progressive diabetic microvascular leakage and occlusion. Etiologic factors include hyperglycemia, hypertension, and possibly genetic factors. Sight-threatening signs include macular edema, retinal or optic disc new vessels, and vitreous hemorrhage. Main goals of therapy are to improve glycemic, lipid, and hypertensive control and ensure that sight-threatening disease is arrested before visual loss occurs. Diabetic retinopathy is the retinal consequence of chronic progressive diabetic microvascular leakage and occlusion. It eventually occurs to some degree in all patients with diabetes mellitus. There are two types: nonproliferative and proliferative. Nonproliferative diabetic retinopathy (NPDR) is the early stage of the disease and is less severe. Blood vessels in the eye may leak fluid into the retina, which leads to blurred vision. Proliferative diabetic retinopathy (PDR) is the more advanced form of the disease. New blood vessels start to grow in the eye (neovascularization), which are fragile and can hemorrhage. This may cause vision loss and scarring of the retina. [Figure caption and citation for the preceding image starts]: Nonproliferative diabetic retinopathy: exudate (yellow arrow), microaneurysms (red arrow), cotton wool spot (white arrow), nerve fiber layer hemorrhage (green arrow) Courtesy of Moorfields Photographic Archive; used with permission [Citation ends]. [Figure caption and citation for the preceding image starts]: Proliferative diabetic retinopathy: new vessels on the optic disk (red circle) Courtesy of Moorfields Photographic Archive; used with permission [Citation ends]. Continue reading >>
Diabetic Eye Disease: Diagnosis, Causes, And Symptoms
By Debra A. Sokol-McKay, MS, CVRT, CDE, CLVT, OTR/L, SCLV Diagnosing Diabetic Eye Disease How Diabetes Affects the Eyes and Vision: Diabetic Retinopathy Eye Examination Guidelines Diagnosing Diabetic Eye Disease Diabetic retinopathy usually has no early warning signs. It can be detected only through a comprehensive eye examination that looks for early signs of the disease, including: Leaking blood vessels Macular edema (swelling) Pale, fatty deposits on the retina Damaged nerve tissue Any changes to the retinal blood vessels To diagnose diabetic eye disease effectively, eye care specialists recommend a comprehensive diabetic eye examination that includes the following procedures: Distance and near vision acuity tests A dilated eye (or fundus) examination, which includes the use of an ophthalmoscope. In a dilated eye examination, it is the pupil that is dilated—not the entire eye. This allows the examiner to see through the pupil to the retina. Visual acuity tests alone are not sufficient to detect diabetic retinopathy in its early stages. A tonometry test to measure fluid pressure inside the eye. A fluorescein angiography test, if more serious retinal changes, such as macular edema, are suspected. Fluorescein angiography is an eye test that uses a special dye and camera to look at blood flow in the retina. Optical coherence tomography (OCT) testing may be used to gain a clearer picture of the retina and its supporting layers. OCT is a type of medical imaging technology that produces high-resolution cross-sectional and three-dimensional images of the eye. Also, an Amsler Grid test can detect early and sometimes subtle visual changes in a variety of macular diseases, including diabetic macular edema. The first image below shows an Amsler Grid as seen with unimpaired vis Continue reading >>
Diagnosis
Print Diabetic retinopathy is best diagnosed with a dilated eye exam. For this exam, drops placed in your eyes widen (dilate) your pupils to allow your doctor to better view inside your eyes. The drops may cause your close vision to blur until they wear off, several hours later. During the exam, your eye doctor will look for: Abnormal blood vessels Swelling, blood or fatty deposits in the retina Growth of new blood vessels and scar tissue Bleeding in the clear, jelly-like substance that fills the center of the eye (vitreous) Retinal detachment Abnormalities in your optic nerve In addition, your eye doctor may: Test your vision Measure your eye pressure to test for glaucoma Look for evidence of cataracts Fluorescein angiography With your eyes dilated, your doctor takes pictures of the inside of your eyes. Then your doctor will inject a special dye into your arm and take more pictures as the dye circulates through your eyes. Your doctor can use the images to pinpoint blood vessels that are closed, broken down or leaking fluid. Optical coherence tomography Your eye doctor may request an optical coherence tomography (OCT) exam. This imaging test provides cross-sectional images of the retina that show the thickness of the retina, which will help determine whether fluid has leaked into retinal tissue. Later, OCT exams can be used to monitor how treatment is working. Treatment Treatment, which depends largely on the type of diabetic retinopathy you have and how severe it is, is geared to slowing or stopping progression of the condition. Early diabetic retinopathy If you have mild or moderate nonproliferative diabetic retinopathy, you may not need treatment right away. However, your eye doctor will closely monitor your eyes to determine when you might need treatment. Work with Continue reading >>
Diabetic Retinopathy
Diabetic retinopathy is a condition that occurs in people who have diabetes. It causes progressive damage to the retina, the light-sensitive lining at the back of the eye. Diabetic retinopathy is a serious sight-threatening complication of diabetes. Diabetes interferes with the body's ability to use and store sugar (glucose). The disease is characterized by too much sugar in the blood, which can cause damage throughout the body, including the eyes. Over time, diabetes damages the blood vessels in the retina. Diabetic retinopathy occurs when these tiny blood vessels leak blood and other fluids. This causes the retinal tissue to swell, resulting in cloudy or blurred vision. The condition usually affects both eyes. The longer a person has diabetes, the more likely they will develop diabetic retinopathy. If left untreated, diabetic retinopathy can cause blindness. Symptoms of diabetic retinopathy include: Seeing spots or floaters Blurred vision Having a dark or empty spot in the center of your vision Difficulty seeing well at night When people with diabetes experience long periods of high blood sugar, fluid can accumulate in the lens inside the eye that controls focusing. This changes the curvature of the lens, leading to blurred vision. However, once blood sugar levels are controlled, blurred distance vision will improve. Patients with diabetes who can better control their blood sugar levels will slow the onset and progression of diabetic retinopathy. Often the early stages of diabetic retinopathy have no visual symptoms. That is why the American Optometric Association recommends that everyone with diabetes have a comprehensive dilated eye examination once a year. Early detection and treatment can limit the potential for significant vision loss from diabetic retinopathy. T Continue reading >>
Facts About Diabetic Eye Disease
Points to Remember Diabetic eye disease comprises a group of eye conditions that affect people with diabetes. These conditions include diabetic retinopathy, diabetic macular edema (DME), cataract, and glaucoma. All forms of diabetic eye disease have the potential to cause severe vision loss and blindness. Diabetic retinopathy involves changes to retinal blood vessels that can cause them to bleed or leak fluid, distorting vision. Diabetic retinopathy is the most common cause of vision loss among people with diabetes and a leading cause of blindness among working-age adults. DME is a consequence of diabetic retinopathy that causes swelling in the area of the retina called the macula. Controlling diabetes—by taking medications as prescribed, staying physically active, and maintaining a healthy diet—can prevent or delay vision loss. Because diabetic retinopathy often goes unnoticed until vision loss occurs, people with diabetes should get a comprehensive dilated eye exam at least once a year. Early detection, timely treatment, and appropriate follow-up care of diabetic eye disease can protect against vision loss. Diabetic retinopathy can be treated with several therapies, used alone or in combination. NEI supports research to develop new therapies for diabetic retinopathy, and to compare the effectiveness of existing therapies for different patient groups. What is diabetic eye disease? Diabetic eye disease can affect many parts of the eye, including the retina, macula, lens and the optic nerve. Diabetic eye disease is a group of eye conditions that can affect people with diabetes. Diabetic retinopathy affects blood vessels in the light-sensitive tissue called the retina that lines the back of the eye. It is the most common cause of vision loss among people with diabetes Continue reading >>
